INTERNATIONAL STUDENT CERTIFICATION OF FINANCES

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1 INTERNATIONAL STUDENT CERTIFICATION OF FINANCES The purpose of the Certification of Finances is to help colleges and universities obtain complete and accurate information about the funds available to international applicants who want to study in the United States. Strict government regulations, rising education costs, and economic conditions have made verifying the financial resources of international applicants essential. Institutions do not have the option of deciding whether to verify the financial resources of their international applicants; financial verification must be made prior to institutional issuance of a Certificate of Eligibility (Form I-20 or DS-2019). This form is designed to standardize financial information provided by applicants to colleges, universities, and U.S. consuls. By completing this form and returning it to the college or university requiring it, an applicant, if admitted, may obtain that college s authorization and issuance of a Certificate of Eligibility (Form I-20 or DS-2019). If parents and/or sponsors are unable to obtain a bank official s verification, it is recommended that institutions forward a copy of the International Student Financial Aid Application to the family for completion. The institution should attach a copy of this certification to the Certificate of Eligibility. U.S. consuls scrutinize the statements of financial resources given by nonimmigrant visa applicants. This certification will help such officials make their decisions and expedite visa issuance. Return directly to the college providing or requesting this statement. The space below is for optional use by issuing institutions for listing student s expected annual budget. Dickinson College Please complete the boxes in the middle of the form (section 8) with estimates in U.S. dollars of how much you and your family can provide for each of the four years you will attend college. The total amount in each column must be equal to, or more than, the anticipated annual cost of attendance ($71,610), the details of which are outlined in the instructions at the end of this document. Applicants who cannot show $71,610 available for all four years should apply for need-based aid. Please note that our financial aid funds for international students are very limited. The completed Certificate of Finance form must include a parent signature, a student signature and a bank official signature. This form, accompanied by a certified bank statement, can be uploaded into your individual application file via your status page, or the documents to studyusa@dickinson.edu for processing. Applications cannot be considered until complete financial information has been submitted. Additional supporting documents (bank certificates, statement or promissory notes) can be submitted but should accompany a completed Certification of Finance form. 1. Your Name 4. of Birth o Mr. o Ms. o Mrs. o Miss Month Day Year Family (surname) Given (first) Middle 2. Permanent Address 5. Place of Birth (country) 6. Country of Citizenship 3. Mailing Address (if different from above) 7. Expected Visa Type o F-1 o G-2 o F-2 o G-3 o J-1 o G-4 o J-2 o H o G-1 o Other (specify) 1

2 8. Enter the expected amount of annual support from the sources listed below. Enter amounts in U.S. dollars. Please PRINT all entries. Use an additional sheet of paper for explanations, if necessary. Student s Sources of Funds Assured Support Projected Support 8a. Personal or Family Savings $ $ $ $ Name of Bank Signature of Bank Official Title Name of Bank Address of Bank 8b. Parents (Money available from sources other than savings.) $ $ $ $ Parent s Name Relationship $ $ $ $ Parent s Name Relationship Please describe the source: Signature of Parent Address 8c. Sponsors (Money available from sources other than parents.) $ $ $ $ Sponsor s Name $ $ $ $ Sponsor s Name Please describe the source: Signature of Sponsor Address Relationship of Sponsor to Student 8d. Your Government $ $ $ $ Name of Agency Enclose a signed copy of your letter of award with this form. TOTAL $ $ $ $ 2

3 9. What is the present exchange rate of your country s currency to the U.S. dollar? (for example, 3,100 pesos = $1) = $1 10. Does your government currently impose restrictions on exchange and release of funds for study in the U.S.? If YES, describe restrictions. 11. Do you have a source for emergency funds once you arrive in the U.S.? If YES, name source. Amount available in U.S. dollars $ 12. How will you pay for your transportation to the U.S.? 13. What is the total amount of money you expect to have when $ you arrive at this institution? 14. Do you plan to remain in the U.S. during the summer? 15. If remaining in the U.S., do you plan to attend summer school? 16. What are the sources and amounts of support available to you during the summer? Sources Amount U.S. $ U.S. $ U.S. $ U.S. $ 17. A CERTIFICATE OF ELIGIBILITY (Form I-20 or DS-2019) will not be authorized until this form is completed and returned to the institution to which you are applying. The institution will attach a copy of this form to your CERTIFICATE OF ELIGIBILITY. Both the form and certificate must be shown to the U.S. consul to obtain a visa. Signature of Student I certify that the information on this form is true, correct, and complete. I understand that any misrepresentation may be cause for refusing or revoking admission. Day Month Year This is to certify that I have reviewed the declaration and attached documents, if appropriate, and approve issuance of a Certificate of Eligibility. FOR OFFICE USE ONLY SIGNATURE OF COLLEGE OFFICIAL TITLE NAME OF INSTITUTION ADDRESS DATE 3

4 This document is to be returned with original signatures and notarized by your bank. We will accept copies or scans, but we suggest that you keep the original copy for your personal file. Total Estimated Cost of Attendance : $54,820 Tuition $13,700 Room & Board $1,250 Books $1,840 Personal Expenses $71,610 TOTAL Minimum Estimated Cost There are 17 sections that must be completed if they apply to your situation. When determining the amount your family can contribute to your cost, please remember you also will be responsible for your travel costs to and from Dickinson as well as required health insurance. The funds listed on the Certification of Finances should be the amount available after you have made allowances for travel and health insurance expenses. 1. Print your name clearly and accurately. Use black ink. 2. Print your permanent address so that the street, city, province, country and postal code can be clearly identified. 3. If you have a mailing address that is different from your permanent address, print it here. 4. Print your date of birth. Make sure it is that same date that is recorded in your passport and your application to Dickinson College. 5. Print your country of birth. 6. Print your country of citizenship. 7. Check the first box: F-1. This is the student visa type for which you are applying a-d require specific sources of funding. a. There are blank columns for your personal funds, parents and sponsors to report the amount of money that you can pay for your educational and other expenses. Please fill out all four columns. You must list the amount of money you can guarantee for the first year s expenses. Then list the projected support you will have for the following three years required to obtain your degree. All blanks must be filled out if support is being given by the source listed at the left. You are required to obtain official certification or notarization of funding from the bank. The bank officer must sign this portion, and a copy of the most recent bank statement of each financial provider must also be included with this form. If the bank will not sign the form, then ask if they will provide a letter on bank letterhead that will verify the amount of money available that you have listed on the form. b. The signature and address of your parent is also required c. If you have a sponsor other than your parents, they will need to sign in the third box, give their address and relationship to you, and provide verification of funds that are listed. This can be done with a current bank statement.

5 d. If the government of your country has a grant or award for students studying abroad, please fill in the name of the agency and include a signed copy of your award letter from that governmental agency. This has to be reported to SEVIS. 9. Please fill this in with the current rate on the date you fill out the form. 10. This is a Yes/No question with explanation needed if checking yes. 11. Check Yes/No and give the name of your emergency fund source and amount of funds available. 12. This can be parent, self or sponsor. 13. Give a specific amount. 14. Please check yes if there is a possibility that you may remain in the U.S. during the summer to attend summer school or travel. Check no if you will go home in the summer. 15. If summer school is a possibility, then check yes. 16. These may be from the same sources as you list for other funding. 17. Please read carefully as your signature is required and certifies that you are telling the truth.